Hip fracture patients have more vertebral deformities than subjects in population-based studies

Abstract

The prevalence of vertebral deformity, estimated in lateral spine radiographs (Th4–L4) using quantitative morphometry, in 64 men and 132 women with hip fractures was compared with the prevalence of vertebral deformity in individuals in two population-based studies. A vertebral deformity of a specific vertebra was defined as a 3, 4, or 5 SD reduction from the normal mean of any of three ratios describing that specific vertebra. The age-adjusted prevalence of individuals with vertebral deformities was higher among the hip fracture patients than among the reference subjects in both genders, with an odds ratio of 3.6 [95% confidence interval (CI) 1.9–6.6] in men and 2.6 (95% CI 1.7–4.1) in women using deformity criterion −3 SD. Also, the number of vertebrae with deformities (−3 SD) in individuals with one deformity or more was greater among the hip fracture patients than among the reference subjects (in men mean 2.3 versus 1.8, P = 0.007; in women mean 3.3 versus 2.0, P < 0.001). Adjusted for age there were more vertebrae with deformities (−3 SD) among female than among male hip fracture patients (mean 3.3 versus 2.3, P = 0.01). We found no differences in the vertebral deformity rates when comparing patients with a per- or subtrochanteric hip fracture with patients with a cervical hip fracture. In conclusion, there is a relationship between vertebral deformities and hip fractures suggesting that a prevalent vertebral deformity could predict an increased hip fracture risk.